Rupture of a Renal Artery Aneurysm During Pregnancy

Jm, Barrett; Rh, Dean; Fh, Boehm

doi:10.1097/00007611-198112000-00037

Cited by 8 publications

(5 citation statements)

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“…Usually, IPRAAs ( Figure 6) are secondary to diseases and injuries involving the vascular network of the kidney including arteriosclerosis, fibrodysplasia, malformations (hemangiomatosis), polyarteritis nodosa as well as recurrent percutaneous intra- parenchymal catheterization, enucleoresection for renal cell cancer, renal stab wounds and percuatenous procedures for kidney stone disease [3,7,[15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

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Intraparenchymal renal artery aneurysms. Case report with review and update of the literature

Porcaro¹,

Migliorini²,

Pianon³

et al. 2004

Int Urol Nephrol

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Increased interest in aneurysms involving the renal artery and its branches has occurred during the past 3 decades. The prevalence of renal artery aneurysms is approximately 0.01%-1% in the general population as well as 2.5% in hypertensive patients undergoing angiography. Intraparenchymal renal artery aneurysms (IPRAAs) are rare since being detected in less than 10% of patients with renal artery aneurysms. The Authors report an unusual case of multiple small intrarenal artery aneurysms associated with a large IPRAA located in the mid portion of the right kidney. Usually, IPRAAs are secondary to diseases or injuries of the kidney vascular network. They are classified as true, false, saccular, fusiform, dissecting, and microaneurysms. Potential complications of IPRAAs include peripheral dissection, thrombosis, hypertension, renal infarction and rupture. IRAAs may be detected incidentally as well as present with urologic symptoms and signs related to complications. Actually, IRAAs are investigated by non invasive modalities including duplex ultrasound, magnetic resonance angiography, spiral three-dimensional computed tomography angiography, and three-dimensional reconstructed rotational digital substraction angiography of the segmental and distant branches of the renal artery. Angiography with intrarterial injection of contrast material is the gold standard in diagnosing IPRAAs. Treatment options for IPRAAs include observation, aneurysmectomy with surgical repair, endovascular procedures, nephrectomy or partial nephrectomy. Observation is indicated for asymptomatic intraparenchymal renal artery aneurysms measuring less than 2 cm in diameter. Surgical repair of IPRAAs includes aneurysmectomy and reconstruction of the renal artery by in vivo or ex vivo technique. The procedure is indicated for IPRAAs causing renovascular hypertension, dissection, urologic symptoms, embolization, local expansion and women of childbearing age with a potential for pregnancy. In recent years, transcatheter arterial embolization has emerged as a simple, useful and effective technique in managing IRAAs. The procedure is performed by transfemoral catheterization as well as by superselective catheterization and embolization of interlobar arteries with 3F microcatheters. Endovascular occlusion is obtained by using gelatin sponge, steel coils, detachable baloons, and conventional non-detachable microcoils delivered through a microcatheter. Nephrectomy or partial nephrectomy are reserved for conditions precluding renal revascularization which include overt RAA rupture, covert RAA rupture, artery-to-vein fistula, renal cell carcinoma, end stage nephropaty, renal infarction, severe ischemic renal atrophy or complex intrarenal aneurysms. Recently, partial nephrectomy by the laparoscopic approach has been proposed for managing IPRAAs and the procedure is considered feasible and safe.

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Section: Discussionmentioning

confidence: 99%

“…IRAAs may coexist with stenotic lesions as well as extraparenchymal aneurysms of the renal artery, and renal cell carcinoma [3,6,15,16,21,22]. IPRAA may be true or false [2].…”

Section: Discussionmentioning

confidence: 99%

Intraparenchymal renal artery aneurysms. Case report with review and update of the literature

Porcaro¹,

Migliorini²,

Pianon³

et al. 2004

Int Urol Nephrol

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“…RAAs, either extraparenchymal, parenchymal, or combined, may be associated with renal artery stenosis, fibromuscular dysplasia, or renal cell carcinoma. 1,[3][4][5][6] Pathogenesis The pathogenesis of RAA is well described. Degeneration of elastic fibers and mediolysis lead to weakening of vessel wall.…”

Section: Renal Artery Aneurysmsmentioning

confidence: 99%

Renal Vascular Lesions: Diagnosis and Endovascular Management

Chimpiri

Natarajan

2009

Semin intervent Radiol

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“…Clin ical evidence showed that the majority of the patients in child-bearing age had ruptures when they were pregnant. It has been speculated that pregnancy may predispose to rupture due to increased cardiac output and hence in creased renal blood flow, hormonal influence on the vas cular wall and increased intra-abdominal pressure [3,8,9]. The last speculation, however, is doubtful because no ruptures occurred during labor or delivery, when intra abdominal pressure rises maximally.…”

Section: Clinical Analysis Of the 43 Ruptured Cases Reported In The Lmentioning

confidence: 99%

“…Moreover, in 2 cases of pregnancy-associated rup tures, the infants were salvaged together with the patients [9,12]. The improved prognosis may be attributed to the development of intensive primary care medicine, cooper ative teamwork with the anesthetist, surgeon, urologist and obstetrician and to improved operative techniques 5 -I I 1950-1959 1960-1969 1970-1979 1980--1949 Fig.…”

Section: Clinical Analysis Of the 43 Ruptured Cases Reported In The Lmentioning

confidence: 99%